The effect of docetaxel or pemetrexed combined with platinum on PD-1 expression and lymphocyte subsets in peripheral blood of patients with advanced non-small cell lung cancer resistant to EGFR-TKI
Objective To investigate the effects of docetaxel or pemetrexed combined with platinum on PD-1 expression and lymphocyte subsets in peripheral blood of patients with advanced non-small cell lung cancer resistant to EGFR-TKI.Methods A retrospective study was conducted on 110 patients with advanced lung cancer who were treated in the Department of Pharmacy of Rugao People's Hospital from March 2021 to April 2023.According to different treatment method,the patients were divided into docetaxel group and pemetrexed group,with 55 patients in each group.The docetaxel group was treated with docetaxel combined with cisplatin,and the pemetrexed group was treated with pemetrexed combined with cisplatin,with 21 days as a cycle.Both groups were treated for 4 cycles.After treatment,the curative effect of the two groups was observed and evaluated.The adverse reactions and quality of life of the two groups were compared.The levels of CA125,CYFRA21-1,Gal-3 and the positive rate of PD-1 were observed and compared between the two groups.The levels of lymphocyte subsets CD3+,CD4+,CD8+ and NK were compared between the two groups.Results The DCR rate was 92.73%in the docetaxel group and 89.09%in the pemetrexed group.There was no significant difference in disease control rate between the two groups(P>0.05).After treatment,the adverse reaction rate of pemetrexed group was significantly lower than that of docetaxel group(P<0.05).After treatment,the improvement rate of quality of life in pemetrexed group was significantly higher than that in docetaxel group(P<0.05).There was no significant difference in serum Gal-3,CYFRA21-1,CA125 levels and PD-1 positive rate between the two groups before and after treatment(P>0.05).After treatment,CD3+,CD4+ and NK were significantly increased(P<0.05).Conclusion There is no significant difference in the effect of docetaxel or pemetrexed combined with platinum on PD-1 expression level and lymphocyte subsets in peripheral blood of patients with advanced non-small cell lung cancer resistant to EGFR-TKI.However,the incidence of adverse reactions in pemetrexed combined with cisplatin treatment is relatively low,and the treatment plan is ideal.It has the value of promotion and popularization in clinical practice.
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